Off-pump versus on-pump coronary artery bypass: meta-analysis of currently available randomized trials
The Annals of Thoracic SurgeryPublished 1 July 2003Open access
Alessandro Parolari, Francesco Alamanni, Aldo Cannata, Moreno Naliato, Leo H. Bonati, Patrizia Rubini
Citations154
SJR quartileQ1
SJR score1.23
SNIP1.38
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
TL;DR
Cumulative analysis of the few prospective randomized studies currently available found a potential clinical benefit of OPCAB, indicating that the avoidance of extracorporeal circulation might result in improved clinical outcomes.
Abstract
Cumulative analysis of the few prospective randomized studies currently available found a potential clinical benefit of OPCAB, indicating that the avoidance of extracorporeal circulation might result in improved clinical outcomes. Further evidence, however, from large randomized trials is needed to assess potential advantages of OPCAB in terms of early outcomes.
Keywords
MedicineEngineering
The LancetEarly and midterm outcome after off-pump and on-pump surgery in Beating Heart Against Cardioplegic Arrest Studies (BHACAS 1 and 2): a pooled analysis of two randomised controlled trials
570 Citations2002Gianni D. Angelini, Fiona Taylor +2 more
Off-pump coronary surgery significantly lowers in-hospital morbidity without compromising outcome in the first 1-3 years after surgery compared with conventional on-p pump coronary surgery.
CirculationEarly Outcome After Off-Pump Versus On-Pump Coronary Bypass Surgery
524 Citations2001Diederik van Dijk, Arno P. Nierich +10 more
In selected patients, off-pump CABG is safe and yields a short-term cardiac outcome comparable to that of on-p Pump CABGs.
The Annals of Thoracic SurgeryInflammatory response after coronary revascularization with or without cardiopulmonary bypass
501 Citations2000Raimondo Ascione, Clinton Lloyd +4 more
CABG on the beating heart is associated with a significant reduction in inflammatory response and postoperative infection when compared with conventional revascularization with CPB and cardioplegic arrest.
The Annals of Thoracic SurgeryNeuromonitoring and neurocognitive outcome in off-pump versus conventional coronary bypass operation
412 Citations2000Anno Diegeler, Robert L. Hirsch +5 more
The off-pump technique appears to be promising in order to eliminate the source of these neuropyschologic impairments following CABG operation, which seems to be strongly associated to CPB and the occurrence of micro-emboli.
The Annals of Thoracic SurgeryOn-pump versus off-pump coronary revascularization: evaluation of renal function
402 Citations1999Raimondo Ascione, Clinton Lloyd +3 more
It is suggested that off pump coronary revascularization offers a superior renal protection when compared with conventional coronary Revascularization with cardiopulmonary bypass and cardioplegic arrest in first time coronary bypass patients.
The Annals of Thoracic SurgeryCoronary artery bypass without cardiopulmonary bypass
300 Citations1992Albert J. Pfister, MohamedA Zaki +7 more
The technique for performing coronary artery bypass grafting without cardiopulmonary bypass (off pump) is described and it is demonstrated that this operation is safe, in terms of mortality and certain indices of morbidity.
The Annals of Thoracic SurgeryOff-pump bypass graft operation significantly reduces oxidative stress and inflammation
293 Citations2000Bashir M. Matata, Andrzej Sosnowski +1 more
Off-pump coronary bypass graft operation on a beating heart significantly reduces oxidative stress and suppresses the inflammatory reaction associated with the use of CPB.
CirculationPredictors of Atrial Fibrillation After Conventional and Beating Heart Coronary Surgery
284 Citations2000Raimondo Ascione, Massimo Caputo +4 more
CPB inclusive of cardioplegic arrest is the main independent predictor of postoperative AF in patients undergoing coronary revascularization, and stepwise multivariate regression analysis identified this role of cardiopulmonary bypass in the pathogenesis of this complication.
Journal of Thoracic and Cardiovascular SurgeryReduced postoperative blood loss and transfusion requirement after beating-heart coronary operations: A prospective randomized study
216 Citations2001Raimondo Ascione, Simon C. Williams +4 more
Coronary artery bypass grafting on the beating heart is associated with a significant reduction in postoperative blood loss, transfusion requirement, and transfusion-related cost when compared with conventional revascularization with cardiopulmonary bypass and cardioplegic arrest.
European Journal of Cardio-Thoracic SurgeryBeating versus arrested heart revascularization: evaluation of myocardial function in a prospective randomized study1
216 Citations1999Raimondo Ascione, Clinton Lloyd +4 more
The results suggest that off pump coronary revascularization is a safe and effective strategy for myocardial revascularizations.
The Annals of Thoracic SurgeryEconomic outcome of off-pump coronary artery bypass surgery: a prospective randomized study
203 Citations1999Raimondo Ascione, Clinton Lloyd +4 more
Off-pump revascularization offers a safe, cost-effective alternative to conventional coronary revascularized with cardiopulmonary bypass and cardioplegic arrest.
European Journal of Cardio-Thoracic SurgeryInflammatory response and myocardial injury following coronary artery bypass grafting with or without cardiopulmonary bypass✩
201 Citations2000Martin Czerny, Harald Baumer +6 more
The findings indicate that multiregional warm ischaemia, caused by snaring of the diseased coronary artery, causes considerably less myocardial injury than global cold ischaemic induced by cardioplegic cardiac arrest.
Journal of Thoracic and Cardiovascular SurgerySerum S-100 protein release and neuropsychologic outcome during coronary revascularization on the beating heart: A prospective randomized study
175 Citations2000Clinton Lloyd, Raimondo Ascione +4 more
Changes in S-100 protein concentration suggest that the brain and/or blood-brain barrier may be more adversely affected during coronary artery surgery with cardiopulmonary bypass than during surgery on the beating heart, but that this may not be reflected in detectable neuropsychologic deterioration at 12 weeks.
The Annals of Thoracic SurgeryComplete revascularization in coronary artery bypass grafting with and without cardiopulmonary bypass
153 Citations2001Martin Czerny, Harald Baumer +6 more
CABG without the use of CPB is effective for complete revascularization in the majority of selected low-risk patients, but the rate of incomplete rev vascularization in this early series of CABGs without CPB has to be stated, and compromises the basic principle of completeRevascularization.
The Annals of Thoracic SurgeryDifferent CABG methods in patients with chronic obstructive pulmonary disease
121 Citations2001Mustafa Güler, Kaan Kırali +5 more
Off-p pump bypass surgical procedures are more advantageous than on-pump methods for patients with COPD because of side effects of CPB on pulmonary function and effects of sternotomy.
European Journal of Cardio-Thoracic SurgeryInterleukin-1, interleukin-6 and myocardial enzyme response after coronary artery bypass grafting – a prospective randomized comparison of the conventional and three minimally invasive surgical techniques✩
89 Citations2000Vassilios Gulielmos, Mario Menschikowski +6 more
Neither CPB nor surgical access influenced the clinical outcome in the treatment of coronary artery single-vessel bypass grafting, suggesting the use of CPB is combined with higher levels of troponin-T and CK-MB as signs of myocardial damage.
The Annals of Thoracic SurgeryOff-pump coronary bypass operations significantly reduce S100 release: an indicator for less cerebral damage?
71 Citations2000W. Wandschneider, Markus Thalmann +3 more
The results of this study suggest that perioperative cerebral impairment is reduced in cardiac operations without the use of extracorporeal circulation, and further large-scale studies are needed to show whether this result is reflected by fewer neurologic deficits.
CirculationPredictors of Atrial Fibrillation After Conventional and Beating Heart Coronary Surgery
57 Citations2001David H. Spodick
CPB inclusive of cardioplegic arrest is the main independent predictor of postoperative AF in patients undergoing coronary revascularization in patients undergoing coronary revascularization.
Current Opinion in CardiologyCoronary artery bypass grafting without cardiopulmonary bypass
26 Citations1998Johan J. Bredée, Erik W.L. Jansen
From the currently available, nonrandomized, prospective studies, the preliminary conclusion seems justified that, in selected patients, off-pump coronary artery grafting is as accurate as conventional bypass grafting, with lower morbidity and mortality.
Journal of Thoracic and Cardiovascular SurgeryUnrealistic expectations arising from mortality data reported in the cardiothoracic journals
22 Citations2002Ani C. Anyanwu, Tom Treasure
Outcomes and magnitudes of effects as reported in these research studies may not be replicable to the same degree in most centers, and extreme caution should be taken in extrapolating results from studies with fewer than 100 patients to larger surgical populations.